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The Journal of Thoracic and Cardiovascular Surgery, Vol 71, 342-347, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
NW Lwason, NL Mills and JL Ochsner
Postoperative alopecia is a minor complication of surgery but a cosmetic
disaster to the patient. Over a 3 year period, 60 cases of occipital
alopecia were discovered in patients following open-heart surgery and 5
cases on other surgical services. In contrast to previous reports, 29
patients had alopecia one year later, presumed to be permanent. Extensive
operations, with prolonged recovery and elective overnight mechanical
ventilation, were common to all. Retrospective analysis and prospective
studies clearly demonstrated that localized scalp pressure was the cause of
the alopecia and that the duration of pressure determined the extent of the
damage. Moving the patient's head at regular intervals during operation and
recovery eliminated the alopecia. The type of head rest used did not modify
the development of alopecia. Electrical injury and the use of heparin,
hypothermia, electrocautery, or hypotension were eliminated as possible
causes. Conclusive evidence correlating periperative events with the
formation of pressure sores in man has not been previously reported.
ARTICLES
Occipital alopecia following cardiopulmonary bypass
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